Non-Standard Management of Target Vessels With the Inner Branch Arch Endograft: A Single-Center Retrospective Study

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dc.contributor.authorTorrealba, Jose, I
dc.contributor.authorSpanos, Konstantinos
dc.contributor.authorPanuccio, Giuseppe
dc.contributor.authorRohlffs, Fiona
dc.contributor.authorGandet, Thomas
dc.contributor.authorHeidemann, Franziska
dc.contributor.authorTsilimparis, Nikolaos
dc.contributor.authorKoelbel, Tilo
dc.date.accessioned2025-01-20T22:01:32Z
dc.date.available2025-01-20T22:01:32Z
dc.date.issued2022
dc.description.abstractPurpose: The purpose of this study was to evaluate early and mid-term results of non-standard management of the supraaortic target vessels with the use of the inner branch arch endograft in a single high-volume center. Material and methods: A single-center retrospective study including all patients undergoing implantation of an inner branch arch endograft from December 2012 to March 2021, who presented a non-standard management of the supraaortic target vessels (any bypass other than a left carotid-subclavian or landing in a dissected target vessel). Technical success, mortality, reinterventions, endoleak (EL), and aortic remodeling at follow-up were analyzed. Results: Twenty-four patients were included. In 17 (71%) cases, the non-standard management was related to innominate artery (IA) compromise (12 with IA dissection, 2 with short IA, 2 with short proximal aortic landing zone that required occlusion of IA, 1 with occluded IA after open arch repair). Two (8%) cases were related to an aberrant right subclavian artery (RSA), 1 patient (4%) due to the concomitant presence of a left vertebral artery (LVA) arising from the arch and an occluded left subclavian artery (LSA), and another patient presented with an occluded LSA distal to a dominant vertebral artery. Three (13%) cases were exclusively related to management in patients with genetic aortic syndromes. Twenty (83%) patients had a previous type A aortic dissection. Ten (42%) patients presented a thoracic or thoracoabdominal aortic aneurysm and 8 (33%) patients an arch aneurysm, 6 of them associated to false lumen (FL) perfusion. There were 2 (8%) perioperative minor strokes, and 1 patient with perioperative mortality. Seven patients presented an early type I endoleak, all resolved at follow-up. Seven patients required reinterventions during follow-up (7 reinterventions related to continuous false lumen perfusion, 3 related to Type Ia endoleak, 2 related to surgical bypass). All patients who presented with FL perfusion had complete FL thrombosis at follow-up. No patient presented aneurysm growth at follow-up. Conclusions: The use of the inner branch arch endograft with a non-standard management of the supraaortic target vessels is a possible option. Despite a high reintervention rate, regression or stability of the aneurysmal diameter was achieved in all the patients with follow-up.
dc.description.funderCook Medical
dc.fuente.origenWOS
dc.identifier.doi10.1177/15266028211058682
dc.identifier.eissn1545-1550
dc.identifier.issn1526-6028
dc.identifier.urihttps://doi.org/10.1177/15266028211058682
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/93846
dc.identifier.wosidWOS:000720648200001
dc.issue.numero4
dc.language.isoen
dc.pagina.final564
dc.pagina.inicio555
dc.revistaJournal of endovascular therapy
dc.rightsacceso restringido
dc.subjectaortic arch
dc.subjectbranch graft
dc.subjectinnominate artery
dc.subjectleft common carotid artery
dc.subjectleft subclavian artery
dc.subjectsupraaortic vessels
dc.subjectgenetic aortic syndrome
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleNon-Standard Management of Target Vessels With the Inner Branch Arch Endograft: A Single-Center Retrospective Study
dc.typeartículo
dc.volumen29
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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